Candesartan successfully prevents left ventricular remodeling after myocardial infarction

Purpose:Left ventricular remodeling is an important factor to define the prognosis of AMI. Although angiotensin converting enzyme inhibitors (ACEIs) have been shown to reduce myocardial remodeling, the effects of angiotensin receptor blocker has not been established. We examined the effect of candesartan on the left ventricular remodeling after AMI.Method:Patients with AMI who underwent coronary intervention were examined. In candesartan group (n=64, mean age 62 ± 12), 4-8 mg of candesartan was administered, and in ACEI group (n=39, mean age 59 ± 11), maximum dose of any ACEIs were administered. Left ventriculography was performed on admission and 6 months, and BNP and IL-6 were measured at 6 months.Results:Restenosis rate was similar in both groups. The increase rate of EF between on admission and 6 months was significantly larger in candesartan group than in ACEI group (p < 0.05). The increase rate of left ventricular end-diastolic volume index (LVEDVI) and left ventricular end-systolic volume index was significantly lower in candesartan group (p < 0.05), indicating the more suppressive effect of ventricular remodeling in candesartan group. BNP at 6 months was significantly and negatively correlated to the EF at 6 months (p < 0.05). BNP and IL-6 levels were tended to be high in patients whose LVEDVI was increased at 6 months.Conclusions:Candesartan is more effective to prevent left ventricular remodeling after AMI than ACEI.